Role Confusion Research Articles

Academic integrity in nursing: What nurse leaders and faculty need to know now.

Integrity is a foundational characteristic of the nursing profession. Ensuring academic integrity in nursing education is critical. The responsibility for academic integrity is shared among students, faculty, and administrators. Using a case scenario, the purpose of this manuscript is to identify and suggest administrative practices that create, maintain, and sustain a climate of academic integrity. This case scenario exposes some points of the inconsistencies in the policies and practices related to academic integrity while identifying best practices for administrators to employ and promote academic integrity at their respective institution. The authors address the inherent complexities of student due process, procedural fairness, faculty role confusion and confidentiality when working through academic integrity violations. As nurse leaders in an academic setting, the authors also share suggestions on how to improve the academic integrity process.

Family Caregivers as Employers of Migrant Live-In Care Workers: Experiences and Policy Implications

ABSTRACT As policymakers globally recognize aging in place as the preferred option for most adults, there is a growing need to supplement family or informal caregiving for frail older adults with formal homecare services, particularly for those who require 24/7 care due to significant physical and/or cognitive impairment. The core objective of this qualitative study was to explore family members’ experiences in employing live-in care workers, particularly the nature of their engagement and the quality of their relationships with these care workers. Our analysis of semi-structured interviews with 35 family caregivers revealed four themes: 1) challenges in acquiring support and developing dependency; 2) negotiation of roles, responsibilities, and moral dilemmas; 3) shifting emotions between trust and suspicion; and 4) role confusion, expectations, and disappointments. The study suggests that families might benefit from formal guidance regarding fostering and maintaining positive relationships in the homecare environment. This paper provides nuanced knowledge that may inform the development of such interventions.

“What are we doing?”: Teacher role confusion in mental health literacy instruction

Research demonstrates a need for an expansion of mental health literacy (MHL) and mental health support in K-12 schools, drawing attention to the role of educators in these initiatives. Through a theoretical lens grounded in role theory, this case study describes the experiences of three middle school English Language Arts teachers as they navigate the planning and implementation of a novel MHL unit of study. Insights are offered into the ways in which teachers navigate this collaborative work and integrate certain tensions as a precursor to increasing role clarity.

Problems of emergency distance learning: The point of view of education stakeholders

Introduction. The urgent transition to distance learning all over the world during COVID-19 pandemic disclosed the problems of assessing the quality of the educational process, including the effectiveness of its organization, the availability of information for students and the peculiarities of supporting students in the process of knowledge acquisition. The purpose of this article is to summarize the problems that arose as part of the urgent transition to remote instruction experienced by education stakeholders: schoolchildren, teachers, schoolchildren’s parents, undergraduate and postgraduate students. Materials and Methods. In order to obtain empirical data, questionnaires were created for each group of education stakeholders, which were submitted in Google forms and posted online. Responses were received from 307 parents, 114 schoolchildren, 175 undergraduate students, 54 postgraduate students and 14 secondary school teachers from different regions of the Russian Federation. The sample consisted of 664 people. Results. The study revealed a range of problems that arose in the process of an urgent transition to distance learning for different education stakeholders. The schoolchildren were technically the worst off, 35% of whom studied using smartphones and tablets, and 36% shared a gadget with another family member. At the same time, students generally had a positive attitude towards distance learning. The greatest psychological problems were found in parents and teachers. Parents were forced to fulfill the duties of teachers for their children, with many complaining that this process was time consuming. Teachers also noted that they simultaneously played two roles in the process of distance learning: a teacher and a parent. Both parents and teachers described burnout symptoms as a result of participating in an activity that was unusual for them. Conclusions. The study identified 4 types of problems faced by education stakeholders: technical, interpersonal, individual and existential. The students, despite the obvious organizational and technical problems, did not experience a negative attitude towards the distance learning process, perhaps because the whole burden of responsibility for learning outcomes fell on adults. A significant individual problem faced by teachers was role confusion, which led to burnout. It has been suggested that the reason for the existential problems seen in most adults is not due to distance learning but to unresolved family issues brought to light by distance learning.

A core competency framework for mental health peer supporters of older adults in a Chinese community: cross-culturally informed Delphi study.

Non-Western literature on the core competencies of mental health peer supporters remains limited. Therefore, we used a three-round Delphi study with peer supporters, service users (i.e. someone using peer support services) and mental health professionals to develop a core competency framework for peer supporters in the Chinese context. The final framework included 35 core competencies, the conceptual origins of which were local (14.3%), Western (20%) and both local and Western (65.7%). They were grouped into five categories in ascending peer supporter role specificity: (1) self-care and self-development, (2) general work ethics, (3) work with others, (4) work with service users and (5) peer support knowledge. A culturally valid mental health peer support competency framework can minimise role confusion and refine training and practice guidelines. In a Chinese context, peer supporters were valued as generic support companions, whereas functions highlighted in the West, such as role modelling, were perceived as less critical.

Probable Causes And Strategies to Address The Issue of High Rate of Debauchery Among The Youth: With Reference to Erik Erikson’s Fifth Stage of Psychosocial Theory of Personality Development

Erik Erikson's theory of psychosocial development posits that individuals advance through eight different stages of life, each marked by a crisis that must be resolved in order to successfully move on to the next stage. According to Erikson's theory, successfully resolving these crises leads to the development of a healthy psychosocial identity, while a failure to resolve these crises can result in a less healthy identity or even identity confusion. The youth of today shows a lot of misconduct in the society and this is attributed to the fact that they fail to resolve the conflict at the fifth stage (identity vs role confusion) of psychosocial theory of personality development. The study reveals some of the probable causes of debauchery among others as mass media, bad peer influence, dysfunctional homes, poor parenting styles and lack of education. The study however suggested some strategies to address the issue of high rate of debauchery; education, building strong relationship with the youth, building confidence and self-compassion and good peer influence. It was therefore concluded that teenagers at this time investigate numerous facets of identity and either acquire a coherent sense of who they are or stay confused about who they are and what they want out of life. Parents, on the other hand, are supposed to provide a good parenting style that will not damage the child in terms of identifying himself or herself. It was recommended among others that school authorities and lecturers in higher institutions should intensify efforts in educating the youth on moral values that will enable them acquire a set of beliefs and values on what is right and wrong which will make them excel. Again, institutions can establish policies and procedures for addressing misconduct, including reporting and investigation protocols, as well as consequences for violating standards of behavior.

Home care experiences of mothers of children with tracheostomies – a qualitative study

Introduction and aim. Parents of children who are addicted to technology have many problems in home care. This study aimed to describe the home care experiences of mothers of children with tracheostomies. Material and methods. The study adopted Husserl’s phenomenological method, a qualitative research design. The sample consisted of 23 mothers of children with tracheostomies followed up in the pediatric pulmonology outpatient clinic of a university hospital. All participants cared for their children at home. Data were collected using a sociodemographic questionnaire and a semi-structured interview questionnaire. All interviews were recorded and transcribed. Results. Children (12 girls and 11 boys) had a mean age of 3.43±3.326 years. The mean age of tracheostomy insertion was 2.8±2.508 years. Seventeen children were on ventilator support. All participants were mothers with a mean age of 32.34±6.00 years. Half the mothers had primary school degrees (52.2%). The interviews revealed one main theme (burnout), three subthemes (social isolation, perception of competence, and regrets), and five categories (burden of care, fear, awareness, decisions, and role confusion). Conclusion. Mothers of children with tracheostomies experience numerous problems when they provide home care. They mostly have difficulty improving themselves and enduring role confusion. We must address the issues mothers of children with tracheostomies face during home care to reduce the prevalence of potential complications and improve the quality of care for both them and their children.

Perspectives on the Intersection of Electronic Health Records and Health Care Team Communication, Function, and Well-being

Understanding of the interplay between the electronic health record (EHR), health care team relations, and physician well-being is currently lacking. Approaches to cultivate interpersonal interactions may be necessary to complement advancements in health information technology with high-quality team function. To examine ways in which the EHR, health care team functioning, and physician well-being intersect and interact. Secondary qualitative analysis of semistructured interview data from 2 studies used keyword-in-context approaches to identify excerpts related to teams. Thematic analysis was conducted using pattern coding, then organized using the relationship-centered organization model. Two health care organizations in California from March 16 to October 13, 2017, and February 28 to April 21, 2022, participated, with respondents including attending and resident physicians. Across data sets, themes centered around the interactions between the EHR, health care team functioning, and physician well-being. The first study data focused on EHR-related distressing events and their role in attending physician and resident physician emotions and actions. The second study focused on EHR use and daily EHR irritants. The 73 respondents included attending physicians (53 [73%]) and resident physicians (20 [27%]). Demographic data were not collected. Participants worked in ambulatory specialties (33 [45%]), hospital medicine (10 [14%]), and surgery (10 [14%]). The EHR was reported to be the dominant communication modality among all teams. Interviewees indicated that the EHR facilitates task-related communication and is well suited to completing simple, uncomplicated tasks. However, EHR-based communication limited the rich communication and social connection required for building relationships and navigating conflict. The EHR was found to negatively impact team function by promoting disagreement and introducing areas of conflict into team relationships related to medical-legal pressures, role confusion, and undefined norms around EHR-related communication. In addition, interviewees expressed that physician EHR-related distress affects interactions within the team, eroding team well-being. In this study, the EHR supported task-oriented and efficient communication among team members to get work done and care for patients; however, participants felt that the technology shifts attention away from the human needs of the care team that are necessary for developing relationships, building trust, and resolving conflicts. Interventions to cultivate interpersonal interactions and team function are necessary to complement the efficiency benefits of health information technology.

Bushfire and Biodiversity Disaster Risk Reduction Tool: A Community-Led Values-Based Bushfire Risk Management Project with Multi-Agency Support to Develop Strategies to Protect Biodiversity and Manage Bushfire in Upper Beaconsfield, Victoria, Australia

Introduction:This Australian-first project explored residents’ values about living in one of Australia’s extreme bushfire risk areas. The project team developed the Upper Beaconsfield Bushfire and Biodiversity Tool (UPB&BT) which delivers tailored local information for residents living in the area. Designed to empower residents to make informed decisions, this user-friendly, online tool visualizes a community’s devastating bushfire history, reveals residents’ values about living in this area, and provides evidence-based actions to protect biodiversity and manage bushfire fuels on private property.Method:Structured decision-making methodology informed the survey design to elicit residents’ values about biodiversity protection and bushfire risk reduction, by inviting approximately 3000 residents to complete the survey. This community-led project applied a participatory approach by inviting collaboration between government, agencies, universities, and community representatives.Results:Key results revealed 75% of respondents valued nature and lifestyle. 51% saw bushfire risk as an important factor for managing vegetation on private land, while 65% either mow or slash to manage vegetation. Synthesized data informed the content of the UPB&BT, which sourced evidence-based knowledge or specialists’ expertise to provide tailored content and actions that met residents’ diverse values. This included the consequences of chosen actions, which helps residents understand the impact of their decisions. However, results identified confusion in roles and responsibilities.Conclusion:This ground-breaking community-led, government-funded project joined with government, agencies, universities, and community representatives to develop a new bushfire and biodiversity tool to help residents understand biodiversity protection and bushfire management in their local community. Results aim to empower residents to make their own evidence-based and informed choices about managing their properties, thereby contributing to the community good. They decide what is important and identify available actions and their potential consequences. Other communities could replicate this process to localize their own disaster risk reduction strategies.

Mainstream Integration of Mental Health Peer Support in Canada: A Mixed Method Study

Mental health peer support was one of the key recommendations of the Mental Health Commission of Canada’s Workforce Advisory Committee (Cyr et al., 2016 [2012]) and highlighted as one way to transform the mental health system in Canada. This mixed methods study explored the work experiences of mental health peer support workers across Canada and their perceptions of integration within mainstream mental health services. The findings revealed that role confusion, stigma, lack of support to practice authentically and peer drift challenged the full integration and participation of peer support workers within Canada’s mental health system. Recommendations to mitigate these challenges are suggested.

Perspectives of patients and healthcare professionals on metabolic monitoring of adult prescribed second-generation antipsychotics for severe mental illness: A meta-synthesis.

We conducted a meta-synthesis of qualitative studies to synthesize the views of psychiatric patients on second-generation antipsychotics (SGAs) and the healthcare providers about the metabolic monitoring of adult-prescribed SGAs. A systematic search was conducted in four databases through SCOPUS, PubMed, EMBASE, and CINAHL to identify qualitative studies of patients' and healthcare professionals' perspectives on the metabolic monitoring of SGAs. Initially, titles and abstracts were screened to exclude articles that were not relevant followed by full-text reading. Study quality was assessed by using Critical Appraisal Skills Program (CASP) criteria. Themes were synthesized and presented as per the Interpretive data synthesis process (Evans D, 2002). A total of 15 studies met the inclusion criteria and were analyzed in meta-synthesis. Four themes were identified: 1. Barriers to metabolic monitoring; 2. Patient related concerns to metabolic monitoring; 3. Support system by mental health services to promote metabolic monitoring; and 4. Integrating physical health with mental health services. From the participants' perspectives, barriers to metabolic monitoring were accessibility of services, lack of education and awareness, time/resource constraints, financial hardship, lack of interest on metabolic monitoring, patient capacity and motivation to maintain physical health and role confusion and impact on communication. Education and training on monitoring practices as well as integrated mental health services for metabolic monitoring to promote quality and safe use of SGAs are the most likely approaches to promote adherence to best practices and minimize treatment-related metabolic syndrome in this highly vulnerable cohort. This meta-synthesis highlights key barriers from the perspectives of patients and healthcare professionals regarding the metabolic monitoring of SGAs. These barriers and suggested remedial strategies are important to pilot in the clinical setting and to assess the impact of the implementation of such strategies as a component of pharmacovigilance to promote the quality use of SGAs as well as to prevent and/or manage SGAs-induced metabolic syndrome in severe and complex mental health disorders.

Social workers' roles and contemporary responsibilities in addiction management

This paper sought to explore and describe the roles and responsibilities of social workers in addiction management. The researchers adopted a qualitative approach and used a multiple-case study design. Purposive and convenience sampling techniques were used to select social workers who specialise in substance/addiction management from two Non-Governmental Organisations and one Government Department. Individual interviews and focus group discussions were used to gather data, then thematically analysed. The study's findings indicated that social service practitioners' roles and responsibilities in the public and private sectors are blurry. It was further found that there is role confusion due to a lack of clarity on this issue as some staff tends to shift their responsibilities. This article provides lenses for higher education institutions in tailoring social work programs to address addiction management issues, as there is a persistent need for the development of a curriculum responding to addiction in social work

Patients’ lived experience and reflections on long COVID: an interpretive phenomenological analysis within an integrated adult primary care psychology NHS service

BackgroundLong Covid is an unknown illness which has been shown to affect sufferers regardless of mild initial COVID-19 or age. There is still a lot unknown about long COVID illness. There has been a call to understand this illness not only from a professional standpoint but also through the lived experience of patients. Patient reported outcomes through lived experience research is one such angle. To date, no research has explored the overall lived experiences and long COVID illness trajectory perspectives of the patients. This study aimed to gather patient reported outcomes of their long COVID through lived experience research. It recruited adult participants aged 18-years and over who had been referred to a primary care integrated psychology service. The study employed qualitative research using semi-structured interviews and Interpretive Phenomenological Analysis methodology.ResultsA total of eighteen participants completed the study. From their lived experiences, the participants uncovered the varied symptoms of long COVID. They also uncovered their lived progression of living with an unknown chronic illness. Common themes included uncertainty, mental and social impacts, and the processes of self-advocacy, mastering their symptoms, subjective recovery and future coping.ConclusionThis study uncovered the lived experience of long COVID in participants. The results from this study uncovered the lived subjective biopsychosocial experiences of long COVID chronic illness. Traditionally, patients receive care and recommendations from healthcare professionals. However, as long COVID is a new illness, this care model was limited. The participants in the current study described being left with a sense of uncertainty and role confusion. However, participants were able to realize their locus of control over their long COVID illness progression. This illustrates that patients have the resources to uncover the unknowns of this new illness which could inform clinical practice and further research. This suggests that that long COVID needs to be approached from a biopsychosocial perspective which emphasises patient involvement.

GREG HEFFLEY’S ROLE CONFUSION IN THE DIARY OF A WIMPY KID (2007): A PSYCHOSOCIAL ANALYSIS

This research is conducted to analyze psychological condition of Greg Heffley, the protagonist in the Diary of a Wimpy Kid (2007) in his early teenage year. Theory used in this research is Erik Erikson’s theory of psychosocial development. Method of this research is qualitative descriptive that uses novel as the primary data. Results of the research shows that Greg Heffley as the protagonist experiences a role confusion due to the transition from childhood to teenage. It is worsened by his unsupportive best friend who still acts like a child when interacting with him. It is found also that Greg Heffley at this stage begins to be aware of his sexual and occupational identity. It is concluded that Greg Heffley is not smooth in transitioning from childhood to teenage with all the situation that he has.

The Self-concept of Adolescent Bully Victim:

Self-concept is the process of an individual's conceptualization of oneself, which is an individual's subjective feelings and a complex combination of conscious or unconscious thoughts, attitudes, and perceptions. In adolescence, identity development occurs if at this time an individual fails to pass it and it will cause several problems such as bad self-image, self-development disorders, low self-esteem, identity changes, and even role confusion which leads to a negative self-concept. This research aimed to investigating the portrayed of negative self-concept of adolescent bully victim in one of the short animated films by Hannah Spangler, Overcomer (2016). This research uses qualitative and interpretative method by analyzing the signs, objects, and interpretants related to Charles Sanders Pierce theory, then analyze the self-concept of the main character by used Muchlisin Riadi’s theory (2013). The data of this research is taken from watching, listening, and observing the short animated film Overcomer (2016). The result of this research shows the negative self-concept that the main character has as an adolescent bully victim, namely having an identity as an unsociable or introverted person, the ideal-self considers herself as a person who is not talented or does not deserve any friends. Low self-esteem makes her think that she is an ugly person. Body image sees herself as a failure, useless, and worthless. As a result of having low self-esteem and body image, Hannah assumes that she has no role in social life.
 Keywords: Animated Short, Charles Sanders Pierce, Self-concept, Semiotic Analysis

Capacity and Control: Superintendent-School Board Relations in Locally Controlled Districts

Purpose: In the wake of school board protests nationwide, it is essential for educational leaders, policymakers, and researchers to understand locally controlled educational governance. The stability of educational districts depends on superintendents navigating relationships with their school boards, yet little research exists that addresses board–superintendent relationships in locally controlled districts. Using theories of local will and capacity, and community power relationships, I examine what factors shape the extent of local control enacted by school boards, and how these factors affect superintendent–school board relations. Research Methods: The qualitative case study design is bounded as one multi-district union superintendent and three rural school boards. Data collection included semistructured interviews, ethnographic observations, and document collection to understand the relational dynamics of local control. Data analysis included in vivo and a priori coding, and the development of analytic matrices. Findings: All boards demonstrated local will and some local capacity, which explained the dimensions of enactment of local control. Rural board capacity—tenure, expertise, and residency of board members—influenced the extent of local control. Cross-case analysis revealed a relationship between board capacity, community capacity, and board–superintendent relationships. These patterns are theorized as local control school board–superintendent relationships typology, based on board capacity and local community capacity. The relationships include role contestation, confusion, collaboration, and dependence. Implications for Research and Practice: The study expands the theory of local capacity to include community and board dimensions and describes the complexities of superintendent–board relationships. The study concludes with recommendations for practice, policy, and research on locally controlled school boards.

A Transcendental Phenomenology of School Counselors' Lived Experiences Transforming Remote Counseling Services During the COVID-19 Pandemic.

The purpose of this study is to explore school counselors' experiences migrating counseling services online during the COVID-19 pandemic. Using a transcendental phenomenological approach, we conducted in-depth interviews with 14 school counselors with a focus on the use of technology and transformative practices. Findings of the study included five composite themes: (a) changes in school counseling services using technology; (b) reaching families for equity; (c) changes in relationship with stakeholders; (d) school counselors' adjustment to grief, loss, and role confusion; and (e) positive outcomes for the future. We discuss the essence of the lived experience and implications for school counselors.

Où finit l’analyse de l’expert et où commence l’appréciation du juge lors d’une expertise ADN en matière pénale ? Analyse critique d’un cas concret

Forensic expertise, specifically DNA identification, is increasingly being sought in criminal trials. It is well established that genetic expertise is an essential tool available to the justice system to provide a criminal response. This is so only if it is exploited by the legal framework governing its administration as criminal evidence. The latter provides that, although the analysis and interpretation of the scientific result are reserved for the expert part, it is nevertheless to the court to assess that part. While in theory, the boundaries drawn by the legislator appear clear, the practice reflects a confusion of role, thus calling into question the very essence of expertise.

Experiences of Early and Enhanced Clinical Exposure for Postgraduate Neonatal Nursing Students at the University of Zambia, School of Nursing Sciences: Lessons and Implications for the Future.

Early and Enhanced Clinical Exposure immediately places postgraduate students in a clinical setting and incorporates continual hands-on instruction throughout their studies. It aims to motivate students by strengthening their academics, improving clinical and communication skills, and increasing their confidence. The underlying principles are to provide a clinical context and to ensure that the patient remains the centre of learning. The School of Nursing Sciences implemented this model in 2021 to produce hands-on Masters-level neonatal practitioners who can work in multidisciplinary clinical contexts. Therefore, this study explored the experiences of postgraduate nursing students on the Early and Enhanced Clinical Exposure model and draw implications for the future. A phenomenological study design was utilized at the University of Zambia, School of Nursing Sciences and comprised of eight Master of Science Neonatal Nursing students in their second year. Convenience sampling was used to select the study site and participants. Data was collected between 15th January 2023 and 31st January 2023 using an in-depth interview guide. Audio recording and notes were transcribed immediately after data collection. Data analysis was conducted using thematic analysis and codes and themes were constructed from the coded data. Ethical clearance and permission were sought before conducting the study. Four major themes emerged from the study: identity and role confusion, challenging and hectic experiences, positive educational experiences, and personal and professional growth. These themes contributed to the promotion of evidence-based practice by helping students to assess, diagnose, and treat various conditions, as well as gain interest, experience, knowledge, and exposure. The model has a significant impact on motivation to learn, as evidenced by reported increased skill level with potential for use in clinical practice. It is recommended that it be implemented in all postgraduate programs for full-time students.

Study of psychosocial problems faced by the wives of alcoholics residing at Indore city

The wives of alcoholics residing face a variety of psychosocial problems that can have a significant impact on their mental and physical health. These problems include emotional distress, financial instability, domestic violence, social isolation, role confusion, health problems, and negative impacts on children. Addressing these problems requires providing support and assistance to these women, including counselling, therapy, and support groups. By helping the wives of alcoholics cope with these challenges, it is possible to improve their overall well-being and reduce the negative impacts of alcoholism on families.